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Testimony: Before the Subcommittee on Information Policy, Census, and National Archives, Committee on Oversight and Government Reform, House of Representatives: United States Government Accountability Office: GAO: For Release on Delivery: Expected at 2:00 p.m. EDT: Wednesday, June 4, 2008: Federal Disability Programs: Coordination Could Facilitate Better Data Collection to Assess the Status of People with Disabilities: Statement of Daniel Bertoni, Director: Education, Workforce, and Income Security: GAO-08-872T: GAO Highlights: Highlights of GAO-08-872T, a testimony before the House Subcommittee on Information Policy, Census, and National Archives, Committee on Oversight and Government Reform. Why GAO Did This Study: Multiple federal programs provide services and support to the approximately 50 million individuals with disabilities in America. While some health and economic data on people with disabilities are currently available, these data have limited use in providing a comprehensive assessment of how these individuals are faring. Additionally, the lack of more useful data limits the federal government’s ability to determine how well federal programs are serving individuals with disabilities. GAO is providing information on (1) the limitations of data currently available to assess the status of individuals with disabilities and (2) how better coordination could help facilitate the collection of such data to inform policy decisions. This statement is based on prior GAO reports, including the May 2008 report on modernizing federal disability programs (GAO-08-635), the 2007 Comptroller General’s forum on disability (GAO-07-934SP), and multiple reports on national indicators (e.g. GAO-05-1); and studies by other organizations, including the National Council on Disability. What GAO Found: Disability policy and programs in the United States have been developed on an individual basis over many years, with success being measured by individual program outcomes rather than with a unified set of national goals and indicators to assess how people with disabilities are faring. In 2005, GAO identified over 20 federal agencies and almost 200 federal programs serving individuals with disabilities that provided a wide range of assistance, such as employment-related services, medical care, and monetary support. These programs often have different missions, goals, funding streams, eligibility criteria, and policies that sometimes work at cross-purposes with other federal programs. In addition, these programs collect data to measure specific programmatic goals but not to provide a set of metrics to assess how federal programs are improving the lives of individuals with disabilities. Although other data on individuals with disabilities are collected on a national level, these data do not share consistent definitions of disability. As a result, these data cannot be easily compiled to create a comprehensive picture of the status of individuals with disabilities, which could better inform federal disability policy and help ensure that beneficiaries are given timely and appropriate supports. GAO and others have acknowledged the need for creating a common set of outcomes for disability programs and the appropriate measures for assessing progress toward shared goals. To facilitate an effort of reaching consensus on desired outcomes for people with disabilities, coordination among the key players in the disability community is required. In May 2008, to better serve people with disabilities, GAO suggested that Congress consider authorizing a coordinating entity consisting of leadership from appropriate agencies that serve this population to develop a cost-effective strategy to integrate services and supports for individuals with disabilities. Consistent with its proposed charter, such an entity should play a critical role in developing agreed-upon, desired outcomes for disability policies and programs and in determining what metrics and data will be used to assess progress toward meeting those outcomes. To view the full product, including the scope and methodology, click on [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-08-872T]. For more information, contact Daniel Bertoni at (202) 512-7215 or bertonid@gao.gov. [End of section] Mr. Chairman and Members of the Subcommittee: I am pleased to be here today to discuss the importance of comprehensive and reliable data to evaluate policy and assess the status of people living with disabilities. About 50 million individuals in the United States are reported to have a disability. Although some health and economic data are currently available, these data have limited use in providing insight into the status of people with disabilities. The lack of more useful data also limits the federal government's ability to determine how well individuals with disabilities are faring and what role federal programs play. My remarks today focus on (1) the limitations of data currently available to assess the status of individuals with disabilities and (2) how better coordination could help facilitate the collection of such data to inform policy decisions. My statement is based on our May 2008 report on modernizing federal disability programs, our 2007 Comptroller General forum on disability, and other prior GAO reports. (See related GAO products at the end of this statement.) We also reviewed studies conducted by other organizations, including the National Council on Disability. We conducted our work in accordance with generally accepted government auditing standards. Those standards require that we plan and perform the audit to obtain sufficient, appropriate evidence to provide a reasonable basis for our findings and conclusions based on our audit objectives. We believe that the evidence obtained provides a reasonable basis for our findings and conclusions based on our audit objectives. In summary, disability policy and programs in the United States have been developed on an individual basis over many years, with success being measured by individual program outcomes rather than with a unified set of national goals and indicators to assess how people with disabilities are faring. In addition, these programs collect data to measure specific programmatic goals but not to provide a set of metrics to assess how federal programs are improving the lives of individuals with disabilities. GAO and others have acknowledged the need for creating a common set of outcomes for disability programs and the appropriate measures for assessing progress toward shared goals. To facilitate this effort, coordination among the key players in the disability community is required. In May 2008, to better serve people with disabilities, we suggested that Congress consider authorizing a coordinating entity consisting of leadership from appropriate agencies that serve this population to develop a cost-effective strategy to integrate services and supports for individuals with disabilities. Consistent with its proposed charter, such an entity should play a critical role in developing agreed-upon, desired outcomes for disability policies and programs and in determining what metrics and data will be used to assess progress toward meeting those outcomes. Background: Multiple federal programs provide services and support to individuals with disabilities. To hold federal agencies accountable for their programs, certain data are collected and used to assess program performance. The Government Performance and Results Act of 1993 (GPRA) mandates that federal agencies develop performance information describing the relative effectiveness and efficiency of federal programs and requires federal agencies to publish strategic and annual performance plans describing specific program activities. While these performance data are critical for assessing program effectiveness, it is unique to each program's mission and has a limited focus. Data that are more comprehensive can help generate a broader perspective on the status or condition of various issues. Indicators, which can produce more comprehensive data, are used as quantitative measures to describe an economic, environmental, social, or cultural condition over time. The unemployment rate, infant mortality rates, and air quality indexes are a few examples of national indicators. There are several types of indicators; some involve specific or related sets of issues, such as health, education, public safety, employment, or transportation, while comprehensive indicator systems pull together only the most essential indicators on a range of economic, environmental, social, and cultural issues. These data can help inform policy areas by clarifying problems and opportunities, identifying gaps in what we know, setting priorities, testing effective solutions, and tracking progress toward achieving goals. The National Council on Disability and other disability experts have advocated for developing better indicators to assess the status of individuals with disabilities. Current Data Limit the Assessment of the Overall Status of People with Disabilities: Disability policy and programs in the United States have been developed on an individual basis over many years, with success measured by individual program outcomes rather than by a unified set of national goals and indicators that assess how people with disabilities are faring. In 2005, we identified over 20 federal agencies and almost 200 federal programs serving individuals with disabilities that provided a wide range of assistance, such as employment-related services, medical care, and monetary support. These programs often have different missions, goals, funding streams, eligibility criteria, and policies that sometimes work at cross-purposes with other federal programs. In addition, these programs primarily collect data to assess whether they are meeting specific goals rather than collect data to make a more comprehensive assessment of how the population they are serving is faring. For example, the Social Security Administration's (SSA) performance measure of the average time to process a disability claim provides information on how SSA is meeting its program goals with respect to service delivery, but the measure does not provide direct information on the well-being of the individuals applying for benefits. While other data on individuals with disabilities are collected on a national level, these data do not share consistent definitions of disability. As a result of this variation, these data cannot be easily compiled to create a comprehensive picture of the status of individuals with disabilities, which could better inform federal disability policy and help ensure that beneficiaries are given timely and appropriate support. Some efforts are being made to improve the quality and usefulness of national data. For example, according to a Department of Labor official, the Bureau of Labor Statistics' national Current Population Survey (CPS) will incorporate new disability questions into its household survey. The CPS questions will be based on existing questions used in the American Community Survey and will use the same definition of disability. These questions could advance federal efforts in assessing the status of people with disabilities. Also, to better define disability terms and concepts, experts have suggested applying a broader approach by creating a conceptual framework within which all disability programs would operate and use standardized disability language. Experts who participated in our 2007 Comptroller General Forum on Modernizing Disability Policy generally agree that a standardized language that can be used by related programs would facilitate consistent data collection, as well as any efforts to assess the status of individuals with disabilities. We and others have acknowledged that a common set of outcomes to measure the federal government's success toward improving the lives of individuals with disabilities is needed. This includes the need to move beyond narrowly focused programmatic measures that capture specific data, like the average time an agency takes to process a disability claim. Experts have suggested using multiple indicators, including quality of life and economic indicators, to develop a more comprehensive picture of how individuals with disabilities are faring. Regardless of the indicators selected, data-reporting requirements should be established to track outcomes to obtain the data needed to inform disability policy. The National Council on Disability's (NCD) recent report Keeping Track: National Disability Status and Program Performance Indicators is consistent with our view that given the complex challenges facing our nation--including serving those with disabilities--indicator systems are useful for measuring progress toward national outcomes, assessing conditions and trends, and helping to disentangle complex program and policy issues.[Footnote 1] Such indicators could also help identify gaps in what we know and help Congress set priorities and track progress toward achieving results. In developing and implementing an indicator system, we have reported that it would be helpful to establish a clear purpose, define target audiences and their needs, and ensure independence and accountability. Finally, we have also called for a strategic plan for all of government, supported by a portfolio of national and outcome-based indicators for key programs. The NCD report and other data sources could help develop such a plan in the area of disability policy regarding metrics needed to assess the well-being of individuals with disabilities. Coordinated Strategy Needed to Determine Desired Outcomes and Assess the Status of People with Disabilities: To determine the status of people with disabilities and to define agreed-upon outcomes, a coordinated effort is needed. In May 2008, we reported that a comprehensive federal strategy for coordinating federal disability programs was lacking. We suggested that Congress consider authorizing a coordinating entity consisting of leadership from agencies that serve people with disabilities. This entity could be responsible for leading the effort on reaching consensus on desired outcomes for federal disability policies and programs. This entity could also determine what measures are necessary to assess progress made toward meeting a unified set of goals for people with disabilities. A coordinated entity could also work to bridge the gap between needed and available information and prioritize further data collection. As Congress considers authorizing such an entity, it should pay particular attention to the membership and goals of this coordinating body. In 1992, Congress authorized the Interagency Disability Coordinating Council (IDCC) to coordinate federal activities to promote independence and productivity of individuals with disabilities. However, to our knowledge, the IDCC has never met or reported to Congress, as required by law. In a prior report, we have identified criteria for successful coordination, including defining and articulating common outcomes and establishing mutually reinforcing joint strategies among federal agencies to achieve identified goals that could be instructive for this purpose.[Footnote 2] Additionally, the coordinated entity could work with the Interagency Commission for Disability Research to identify what data are available and what data should be collected to assess how individuals with disabilities are being served and how they are faring overall. Mr. Chairman, this concludes my statement. I would be happy to answer any questions you or other members of the subcommittee may have at this time. GAO contact and Staff Acknowledgments: For further information regarding this testimony, please contact Daniel Bertoni, Director, Education, Workforce, and Income Security at (202) 512-7215, or bertonid@gao.gov. Shelia Drake (Assistant Director), Susannah Compton, Jean Cook, and Anjali Tekchandani also contributed to this statement. [End of section] Related GAO Products: Federal Disability Programs: More Strategic Coordination Could Help Overcome Challenges to Needed Transformation. [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-08-635]. Washington, D.C.: May 20, 2008. A Call for Stewardship: Enhancing the Federal Government's Ability to Address Key Fiscal and Other 21st Century Challenges. [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-08-93SP]. Washington, D.C.: December 2007. Highlights of a GAO Forum: Modernizing Federal Disability Policy. [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-07-934SP]. Washington, D.C.: August 3, 2007. Results-Oriented Government: Practices That Can Help Enhance and Sustain Collaboration among Federal Agencies. [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-06-15]. Washington, D.C.: October 21, 2005. Federal Disability Assistance: Wide Array of Programs Needs to Be Examined in Light of 21st Century Challenges. [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-05-626]. Washington, D.C.: June 2, 2005. Informing Our Nation: Improving How to Understand and Assess the USA's Position and Progress. [hyperlink, http://www.gao.gov/cgi- bin/getrpt?GAO-05-1]. Washington, D.C.: November 10, 2004. Forum on Key National Indicators: Assessing the Nation's Position and Progress. [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-03-672SP]. Washington, D.C.: May 2003. [End of section] Footnotes: [1] National Council on Disability, Keeping Track: National Disability Status and Program Performance Indicators (Washington, D.C., 2008). [2] GAO, Results-Oriented Government: Practices That Can Help Enhance and Sustain Collaboration among Federal Agencies, [hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-06-15] (Washington, D.C.: Oct. 1, 2005) [End of section] GAO's Mission: The Government Accountability Office, the audit, evaluation and investigative arm of Congress, exists to support Congress in meeting its constitutional responsibilities and to help improve the performance and accountability of the federal government for the American people. GAO examines the use of public funds; evaluates federal programs and policies; and provides analyses, recommendations, and other assistance to help Congress make informed oversight, policy, and funding decisions. GAO's commitment to good government is reflected in its core values of accountability, integrity, and reliability. 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